Orthopedic tutor for spine and method

ABSTRACT

The tutor of this invention is made up of a support ( 1 ) to be fixed to the chest of the user with a chin rest ( 2 ) being connected to the support ( 1 ) through a hinge ( 7 ) and also being anchored at an element ( 3 ) provided on the patient&#39;s neck, and of a plate ( 4 ) positioned on the convexity of the patient&#39;s dorsal curve and having applied thereto a posteroanterior thrust. The said chin rest ( 2 ) is engaged to a means ( 8 ) articulated to the support element ( 1 ) in a central position with respect to the chin rest ( 2 ) and is able to generate and adjust an anteroposterior upwardly oblique thrust F on the chin of the user. The method for using the said tutor implies putting on and fitting the chin rest, then manually activating the means ( 8 ) engaged on the chin rest ( 1 ) so as to obtain, on the chin of the user, who keeps his/her mouth shut and head reclined forward, a desired anteroposterior upwardly oblique thrust F which, via the user&#39;s yaw, transmits to the atlas bone (first vertebra of rachis) an equal force R whose horizontal component Ro is cause for a retropositioning of the cervical curve, and whose vertical component Rw is cause for an upwardly directed stretching and, consequently, a direct straightening of the underlying dorsal curve.

TECHNICAL FIELD

The invention refers to orthopedic apparatuses. In particular, the object of the invention is an orthopedic tutor for bloodless correction of vertebral deformities and the method for the use thereof.

An induced active self-correction is proposed which is operated by a retropositioning of the cervical curve and by a concurrent upward stretching thereof that are obtained by applying, on the patient's chin, an upward oblique antero-posterior thrust F which, by means of the yaw, is transmitted to the Atlas bone (first vertebra of the rachis) with an antero-posterior horizontal component F₀ and a vertical component F_(V) (FIG. 1). The correction of the cervical curve thus obtained causes the intervention of the paravertebral and intercostal muscles the involvement of which generates also the general stabilization of the rachis.

BACKGROUND ART

As everybody knows, the backbone consists of seven cervical vertebrae for sustaining the neck and head, of twelve dorsal vertebrae for sustaining the chest, of five lumbar vertebrae for sustaining the abdomen and of two bones which close the pelvis cavity (sacrum and coccyx).

The backbone, when viewing it in the front plane, is rectilinear, whereas in the sagittal plane exhibits four anteroposterior curves, two of which having anterior convexity (cervical lordosis and lumbar lordisis) and two having posterior convexity (dorsal kyphosis and sacral kyphosis).

The vertebrae of the cervical, dorsal and lumbar regions are articulated to each other to make it possible, with their elongation and compression, to absorbe the variable stresses by preserving the integrity of the articular structures and favoring the kinematic capacity of the whole vertebral complex and of the structures correlated therewith.

However, all the vertebral curves have a range within which they must remain able to exert their function correctly. When the degree of curvature increases excessively, the curves become a negative factor for the stability and functionality of the rachis, inasmuch as they loose their shock-absorbing capacity.

The pathologic increases of the physiologic vertebral curves are called hyperlordosis and hyperkyphosis, which are very serious pathological pictures involving also alterations of the functionality of the paravertebral muscles.

The most common pathological picture of vertebral curves is the dorsal hyperkyphosis, that is, a dorsal curve exceeding 35°. Such an alteration may occur both in the childhood, owing to vertebral osteochonondrosis (suffering of growth nuclei of the vertebral bodies), and in the senile age, owing to osteoporosis which determines the compression of the vertebral bodies, and to vertebral arthrosis.

At present, the bloodless treatment of the dorsal hyperkyphosis is obtained with various orthopedic systems.

A first system consists in exerting a pressure in horizontal direction onto the dorsal convexity and, at the same time, a horizontal counter-pressure onto the sternum and abdomen, respectively. This system is implemented by using a waistcoat commonly called (“of three points of action type”); however, this system exhibits the drawback that the counter-pressure exerted onto the abdomen has a limited effect inasmusch as the members held therein reduce significantly the thrust thereon in the lower region of the dorsal curve.

A further system consists in exploiting the continuity of the dorsal spine with the lumbar spine and in causing a passive pressure onto the dorsal curve, following a reduction of the lumbar lordosis, obtained by a horizontal pelvic anteroposterior thrust and a horizontal counter-thrust onto the convexity of the dorsal curve and a stimulus provided by the cervical collar for a self-correction which results practically ineffectual. This system is implemented by the Milwaukee corrective waistcoat, and is suited exclusively for teenagers with a growing neck, while it is inapplicable and ineffectual in adults and elderly people. Moreover, the passive pressure onto the dorsal curve determines the hypotonicity of paravertebral and intercostal muscles so that, in many cases, upon the removal of the corrector, there is occur often the reapperance of the hyperkyphosis and instability of rachis.

Yet another system consists in exerting an upwardly directed pull of the whole backbone. This is obtained with a HALO type apparatus by which a plurality of pull points are fixed on the skullcap and a downwardly directed thrust is exerted onto the pelvis.

In the state-of-the art, none of the known system provides for the correction of the dorsal hyperkyphosis by acting directly on the cervical curve from above and involving the paravertebral and intercostal muscles.

DISCLOSURE OF INVENTION

Reduced to its essential construction, said orthopedic tutor comprises:

-   -   a support element (1) with its front part intended to remain         adherent to the patient's chest, with the upper part being         provided with two stretched apart and symmetrical edges (11),         centrally joined to a chin rest (2) able to oscillate vertically         for accomodating the patient's chin, and to be anchored         laterally to an element (3) provided on the patient's necks         close to the nape;     -   a plate (4) of rigid material to be positioned in correspondence         of the convexity of the patient's dorsal curve and supported in         position by two belts (5) passing on the patient's shoulders and         apt to be anchored to the upper part of the support element (1):         the intensity of the posteroanterior thrust Fp to be exerted         onto said plate (4) being adjustable by means of a belt (6)         tightened around the patient's body and fixed to the element (1)         with the interposition of a buckle (7) provided on the two sides         of the lower part of support element (1).

More particularly:

-   -   the said support element (1) is made of rigid material, with its         front part (10) suitably shaped to ensure the application         thereof in adhering condition to the patient's chest;     -   the said chin rest (2) is made to oscillate vertically with         respect to said support element (1) by means of a hinge (7)         shaped as a horizontal pivot provided in the lower part of the         same chin rest and being acted upon by said thrust F (with         closed mouth and forwardly reclined head of the patient) which         is generated by a cam (8) which is in turn articulated to the         fixed element (1) in front of the chin rest, the manual rotation         of said cam (8) making it possible to adjust the intensity of         thrust F.

As an alternative to said cam, use can be made either of a screw with relevant nut screw, or of a spring whose longitudinal axes shall be perpendicular to the chin rest (2).

A retainer element, of a type known per se, is provided for holding tightly the element (8) on the chin rest.

The method for using the orthopedic tutor according to the invention comprises:

-   -   putting on the tutor by laying the support (1) onto the user's         chest and fixing it therein by belt(s) (6) anchored to the         dorsal plate (4) and wrapped around the body by means of the two         belts (5) also anchored to the plate (4) and passing over the         shoulders;     -   fitting the chin rest (2) by tensioning the anchoring elastic         band (3) at the back of the nape;     -   activating the means (8) intended to exert on the user's chin         the desired thrust F which acts substantially in the         anteroposterior direction with respect to the user and is         upwardly oblique, that is, gives rise to a horizontal component         F₀ directed toward the user and a vertical component F_(V)         directed upwardly;     -   transmitting to the user's atlas bone, that is, to the first         vertebra of his/her cervical curve which is connected to the         skull, a force R of intensity equal to the thrust F which         results as having a horizontal anteroposterior component R₀         equal to the component F₀ of thrust F and a vertical component         R_(V) upwardly directed and equal to F_(V); said force R₀ on the         atlas determining a retropositioning of the user's cervical         curve and, at the same time, the said R_(V) determining an         upwardly directed stretching of same cervical curve.

For the correction of the dorsal curve by the said method, provision is made advantageously for applying a cooperating horizontal posteroanterior thrust F_(P) on the plate (4) placed on the convexity of the dorsal curve, through a proprioceptive stimulation of the muscle activity: this being possible by tensioning the belt(s) (6) of the tutor.

The advantages obtainable with the orthopedic tutor according to the present invention are outstanding. The major advantage lies in the involvement of the paravertebral and intercostal muscles, with the additional effect of contributing to the straightening of the cervical and lumbar lordosis, as well as of the hyperkyphosis associated with the scoliosis (deviation of the backbone on the frontal plane).

A further advantage is that it can be applied to adults and elderly people and in most serious cases where there is a forward drop of the rachis due to the reversal of the cervical lordosis, as well as in serious forms of cervical arthrosis and slipped cervical disc, owing to the decompression effect onto the nervous structures.

Further advantages lie in the possibility of using a tutor of simple and cost-effective manufacturing, of easy application, allowing a handy adjustment of the thrust onto the chin by the same patient, and of such good tolerability and functionality as to be wearable also for a few hours per day.

Besides, the correction of the cervical curve thus obtained determines the crucial intervention of the paravertebral and intercostal muscles whose involvement generates and ensures also the general stabilization of the rachis.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a section view of the head, taken on the plane of thrust F, wherein all the forces are represented ovurtumed through 90° on the plane of the drawing, where:

-   -   F is the upwardly oblique and anteroposterior thrust to be         applied on the user's chin;     -   F₀ is the horizontal anteroposterior component;     -   F_(V) is the upward vertical component;     -   F₁=F₂=½ F are two equal parallel forces passing through the         points T1 and T2 of attachment of the yaw to the skull;     -   R is the resultant of said two forces F₁, F₂ which is         transmitted to the atlas bone and has intensity equal to F, with         the anteroposterior component R₀ and upward vertical component         R_(V).

FIG. 2 is a front view of the tutor in use.

FIG. 2 a is an alternative solution of the tutor of FIG. 1.

FIG. 3 is a side view of the tutor.

FIG. 3 a is an alternative solution of the tutor of FIG. 3.

FIG. 4 is a rear side of the tutor. 

1. Orthopedic tutor for bloodless correction of the vertebral deformities, comprising: a support element (1) to be fixed to the patient's chest, a chin rest (2) for accomodating the chin of the patient, said chin rest being connected below to the support element (1) by a hinge having horizontal axis and whose side ends are fixed to a bearing element (3) located on the patient's nape, means (8) intended to exert a thrust F onto the patient's jaw in an upward oblique anteroposterior direction, plate (4) to be positioned in correspondence of the convexity of the patient's dorsal curve for exerting a posteroanterior force Fp thereto, characterized in that: said element for bearing the chin rest (2) is collar which in use allows the head to move freely, and that: said means (8) make up a hand-operated pusher device acting on the chin rest (2) with a force of presettable inclination and gradually increased intensity that can be subsequently released, said force being able to determine a horizontal anteroposterior displacement in combination with an upward vertical displacement of the patient's rachis.
 2. Orthopedic tutor according to claim 1, characterized in that said collar (3) for bearing the chin rest is a ribbon of corsets fabric whose free ends are fixed to the chin rest (2) by pressure buttons.
 3. Orthopedic tutor according to claim 1, characterized in that the motive member of said pusher device (8) is a cam solid to a horizontal shaft parallel to the axis of rotation of the chin rest (2) and idly mounted on a frame which is in turn solid to said support (1) but with the possibility of rotating vertically so as to change the position of the cam, as well as the inclination and travel thereof, with respect to the chin rest (2).
 4. Orthopedic tutor according to claim 1, characterized in that said cam (8) is made to act onto the chin rest (2) either directly or with the interposition of a follower member suitably seated in the chin rest (2) and interlocked with a spring for the return thereof to the rest position.
 5. Orthopedic tutor according to claim 4, characterized in that one end of the shaft carrying the cam (8) is provided with a handwheel for manually controlling the rotation thereof.
 6. Orthopedic tutor according to claim 1, characterized in that said cam (8)-carrying frame is fixed to the support by screw means.
 7. Orthopedic tutor according to claim 1, characterized in that said cam (8)-carrying frame is provided with a goniometer and relevant frame-locking element in order to correctly position the cam (8) with respect to the chin rest (2).
 8. Orthopedic tutor according to claim 1 characterized in that the motive member of said pusher device (8) is a pair of like parallel and vertical cams, identically positioned on opposite side with respect to the vertical center plane of the chin rest (2), which are solid to a common shaft also acting as an idle axis of said hinge of chin rest (2).
 9. Orthopedic tutor according to claim 7, characterized in that one end of said rotating shaft, on which the two cams (8) are mounted, is provided with a handwheel for the manual control of rotation.
 10. Orthopedic tutor according to claim 7 characterized in that, associated with said shaft cam carrying the pair of cams (8), is a goniometer with relevant blocking element for properly positioning said two cams (8) with respect to the chin rest (2).
 11. Orthopedic tutor according to claim 7 characterized in that each of said pair of cams (8) is made to act onto the chin rest (2) either directly or with interposition of a follower member suitably seated in the chin rest (2) and interlocked with a spring for the return thereof to the rest position.
 12. Orthopedic tutor according to claim 1, characterized in that the motive member of said pusher device (8) is a screw rotatively mounted to a corresponding nut screw fixed in said support (1), the head of said screw being provided with a handle for the manual rotation thereof and the flat end thereof is intended for acting on the chin rest (2) either directly or with the interposition of a selvage fixed to the chin rest (2).
 13. Orthopedic tutor according to claim 12, characterized in that the motive member of said pusher device (8) is a pair of like screws, parallel and identically positioned on opposite sides with respect to the vertical center plane of the chin rest (2) and rotatively mounted within corresponding nut screws fixed in said support (1).
 14. Orthopedic tutor according to claim 12, characterized in that each of said two screws that make up the pusher device (8) is made to act onto the chin rest (2) with the interposition of a compression spring fitted into a corresponding seat of the chin rest (2). 